follow up on my colonoscopy with GI/path

Hi All:

So I had my colonoscopy two weeks ago and yesterday I had my follow up with him and reviewed my path results.  The imuran is doing very well by me with no issues.  I have one bm a day with no urgency, blood, mucus, etc...   One year ago I had two patches of inflammation, one in the ascending colon and another patch in the rectum.  The area in the ascending colon is almost completely healed basically gone but the area in the rectum is a little angrier and a little larger, about 50 cm in general. 

The good news is that the area in the recutm is much easier to treat because it is very accessible with the use of canasa suppositories.  We talked about lowering the dosage of imuran from 150 to 100 mg but will wait 6 months to see how the canasa is treating the rectum.  In the spring we will do a flex sigmoid scope and determine how the rectum looks.  If it is has healed the Imuran can come down in dosage.  If not stay at the 150 or even consider going back to the 200 mg dosage. 

Overall very good news in my opinion.  He considers me in clinical remission and with a small patch that needs to be handled.  He also said I could consider going from annual colonoscopies to colonoscopies to being scoped every 2-3 years.  

He also said that I didn't need the Rowasa retention enemas because he patch was so low that the canasa is the appropriate one to use and enemas would be over kill  because it goes much higher up the colon than needed. 

Just to keep you guys and gals in the loop.

MyUC 

THanks so much for the update MyUC. I always like to hear from you and it is great to hear how well your colon has healed. Hopefully the Canasa will take care of that last bit of inflammation. Good luck and keep us posted!
B

Thanks hateuc.  I really appreciate your positive vibes.  It makes me want to pop in here and post now and again.  Yeah I am hoping to get rid of that last bit of inflammation.  My GI doc is anticipating a completely healed colon within 6 months. 

Thanks again hateuc

MyUC

I think it's interesting. It's interesting to learn that what Canasa helps vs. what enemas help. I just stick it all up there, hoping something sticks.

Good progress. Carry on!

Q:

Not exactly sure where the inflammation is in the ascending colon.  My GI doc really wasn't that concerned because it is almost gone, completed healed.  The path came back mild colitis.  As a side note my transverse, descending and sigmoid all showed focal paneth cell metaplasia one year ago.  This is a process where the colon after getting ulcers for years responds by changing into a hardier tissue.  In lab experiments if the insulting process continues unchecked it would eventually turn into colon cancer.  This year the colonic mucosa was completely normal.  My doc explained that my pathology in terms of metaplasia not dysplasia was my colon healing itself.  Now it is completely healed.

Yes I am eager to heal the rectum which canasa should do the trick.  I totally believe that the rectum can be the most stubborn area to heal since this is where flares start and is usally the last place to heal.

In closing 192 views and only 3 people responded.  I was hoping my posts would help more people but I guess my colon is kind of boring.  Oh well.

MyUC

Q:

Every GI doc I have ever seen has been very consistent with UC.  After 9 colonscopies with over 100 biopsy samples every single diagnostic test has come back UC.  I have even had an upper GI scope with biopsies and there has never been a single involvement of my small intestine.  As far as the patchiness in concerned my GI doc says that this is the way my colon is healing.  I went from a very bad case of pancolitis with every single segment of my colon being involved with UC to over 95% being UC free.  Even the ascending colon is healing just at a slower rate.  Chron's has never ever been mentioned. 

As far as taking oral 5 ASA's my doc and I both feel that they didn't control my UC that well or at all towards the end.  Now that it is basically localized to a small patch in the rectum we are hoping to get rid of it with the canasa and at least lower the Imuran if not get off it all together and try to stay on an oral 5 ASA.  We shall see in 6 months when we do the flex sigmoid.  At least we got the Canasa in the mix.

The PCM is a thing of the past.  Meaning it's no longer there and the only reason it came up is because I was really on top my UC and was on top of the path reports.  The colon now just shows normal colonic mucosa in most of my colon.

Again thanks for your imput Q, I really appreciate it.

MyUC

MyUC,

I agree with hateuc. Your posting still is interesting/helpful to the rest of us, even if we don't have a response or advice. I just found out I have UC, so I am pretty uneducated on the matter. Reading this sort of thing helps me out, considering I have a ways to go. So thank you for posting and helping/benefiting us with your story.

Also, really glad to see things are looking up for you.

Thanks again.

PS- I see that you're a dentist. I will be applying to dental school this summer! Crossing my fingers.

Mnorthernlight and hateuc:

Thanks again for the kind words.  I don't want to come across the wrong way, that I just need a lot of attention.  I guess I have been waiting for this last colonoscopy to put things in perspective and it did.  My colitis is really well controlled now with very little attention to toilets in general.  I have a bm every day or every other day, just once.  Nice and formed like the old day pre-UC.  I will drop the attention getting comments.  I appreciate both your kind words and encouragement. 

Good luck Mnorthernlight on your application to dental school.  I love being a dentist and I highly recommend the profession.  My fingers are crossed for you too.  As far as diet I eat what ever and when ever I want.  Nothing in my diet affects my UC.  In fact I love spicy food.

Happy holiday all,

MyUC

I think its great news about your colonoscopy- and great news about your symptoms being pretty much under control, dare we say *remission* 

 I don't know much about Imuran, so I will comment on the canasa.  If it were me, and I felt this good, I would probably stick to the canansa once a day until an appt at my gi for a sig showed things were all clear.  In fact, i would still think about asking  the dr about the rowasa. The reason being- the rowasa(the 4gm) has more concentrated amounts of mesalamine.  more bang for your buck, ya know?  I always thought of canasa as my back up medicine, a way to coat my colon in meds during the day.

I have had uc throughout my colon- so far i have responded well to increased oral mesalamine and rectal meds(rowasa ) and some diet changes while in a flare.           At my last gi appt in oct (based on a lingering flare and some occasional  lingering symptoms of blood streaked bms) my gi did a flex sig on the fly( meaning no formal prep and just on whim to see what was going on down there).  My rectum was all clear, yay! but still some mild inflammation in my sigmoid (well at least as far up as she could go without proper prep).  I just think that the rowasa is more potent stuff and i fully credit it with healing my rectum.  I must be an oddball because everyone else here says that the rectum is the last to heal.

whatever you decide to do, obviously you are on the right track.